Risk Management Tools & Resources


CASE STUDY: Failure to Identify Sepsis and Initiate Treatment Leads to Patient Death

Jeanne E. Mapes, JD, CPCU, CPHRM


Case Details

The patient in this case was a 49-year-old female who had a significant medical history, including chronic obstructive pulmonary disease (COPD), coronary artery disease, hypertension, and hyperlipidemia. Her surgical history included placement of two coronary stents and vascular surgery on her left leg.

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Improving Identification and Management of Sepsis in Outpatient Settings

Laura M. Cascella, MA, CPHRM


Sepsis is a debilitating, life-threatening, and costly condition that represents a persistent challenge to healthcare providers in terms of early diagnosis and management. Although sepsis is a leading cause of death in the United States1 and a significant burden on patients and healthcare organizations, knowledge about — and recognition of — the condition is still problematic among many healthcare professionals and the public.

Various factors may contribute to lack of sepsis awareness and delays in diagnosis. First, the terms and definitions associated with sepsis have changed over the years, and lack of standardization has led to multiple definitions in use at the same time. Additionally, identification criteria associated with the terminology and definitions also have varied.2

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The Challenge of Difficult Patients: Risk Management Strategies for Handling Inappropriate Patient Behaviors


Difficult patients represent one of the most challenging situations that doctors and other healthcare professionals encounter. Dealing with these patients can be emotionally and mentally draining — as well as increasingly frustrating — for practitioners and their staff members.

Additionally, inappropriate patient behaviors can compromise the provider-patient relationship, and patients might be at increased risk for misdiagnosis and more likely to have negative outcomes.1 Difficult patients also might be more likely to file a lawsuit as a result of perceived negative encounters.

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Nonverbal Communication as an Essential Element of Patient-Centered Care


Effective verbal communication is the bedrock of high-quality, patient-centered care. Healthcare providers undoubtedly are aware of the continued emphasis and importance placed on verbal communication through various quality measures and standards. However, good nonverbal communication — facial expressions, gestures, eye contact, posture, and tone of voice — also is essential. Research suggests that the majority of daily communication is nonverbal, which stresses the importance that this aspect of communication plays in human interactions.1

The ability to understand and use nonverbal communication, or body language, is a powerful tool that can help healthcare professionals connect with patients in a positive way and reinforce mutual understanding and respect.2

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Record Retention Basics for Healthcare Practices


Healthcare practices generate and maintain many different types of records, including patient health records and business records. These records help each organization maintain critical information and deliver quality services and care.

To protect records, healthcare practices should develop and implement formal record retention policies and procedures. Doing so will help establish a systematic and organized approach to record management. Further, formal policies and procedures may help defend against allegations of spoliation — i.e., that records were deliberately or maliciously destroyed.

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Ethical Concerns About Terminating a Provider–Patient Relationship During the Pandemic

The outbreak of the coronavirus disease 2019 (COVID-19) has rocked the healthcare community, sending ripples of uncertainty in relation to patient and healthcare worker safety, financial security, ethical decision-making, standards of care, and beyond. Decisions, choices, and actions that were already difficult prior to COVID-19 — such as terminating a provider–patient relationship — have become even more complex in the face of the ongoing pandemic.

Yet, these situations will undoubtedly still arise, particularly as healthcare professionals resume services, triage patient care needs, and adapt to developing standards and practices precipitated by the evolution of the virus.

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Ineffective Communication in Cardiology: Addressing a Persistent Risk Factor in Malpractice Claims

Providing coordinated and competent patient care involves precision at many points in the clinical process, particularly when sending and receiving information. Although information transfer seems like a fairly straightforward process, the complex and dynamic nature of healthcare presents numerous communication obstacles.

As a result of these obstacles, ineffective communication among healthcare professionals is one of the leading causes of medical errors and patient harm.1 Further, analysis of malpractice claims shows that communication is a common contributing factor in claims across various specialties.2

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Assessing Diagnosis-Related Allegations in Otolaryngology Claims: The Complexities of Clinical Reasoning

Diagnostic errors are a persistent issue in healthcare, and they are top liability risk for many medical specialties. A review of 10 years of closed claims data for otolaryngology shows that diagnosis-related allegations account for almost 1 in 5 claims.1

Although the volume of diagnosis-related claims is significantly lower than the volume of claims for the top allegation category — procedural performance, which accounts for almost half of all otolaryngology claims — these cases still can be consequential in terms of poor patient outcomes and total dollars paid (i.e., expense and indemnity dollars).

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